Objectives week 1 Flashcards
List the vitals
Heart rate
Respiratory rate
Blood pressure
Temperature
Three most common locations for checking a heart rate.
Radial artery
Brachial artery
Carotid artery
How long do you check a heart rate?
If RRR, measure for 15 seconds and x4. If not, count for full 60 seconds.
How long should you measure respiratory rate?
A full 60 seconds
Normal heart rate?
60-100 bpm
Normal respiratory rate?
12-20 respirations per minute
What is the gold standard location when taking a temperature?
Rectal
Will axillary be higher or lower than oral?
Lower
When using the tympanic thermometer, which way do you face the tool?
Towards the eyes, otherwise you can get an abnormally low reading.
What other observations would be made while measuring respirations?
Fruity breath, how hard it is to breathe, what position the person has to place themselves in, accessory muscles
What populations have lower or higher of the following:
BP
RR
Temperature
BP: higher = children and hypertension, lower = elderly and hypotension
Temp: higher = children (febrile seizures), lower = elderly (can mask fevers)
What are some alternative places to measure BP?
Thigh, wrist, and forearm
What are five common errors in measuring BP?
- Stethoscope is not turned to bell
- Using bell
- Earpieces pointing toward eyes
- Bell is sealed
- Brachial artery is found
How do you increase Korotkoff sounds?
Place cuff on arm Have them raise arm above head Inflate cuff to 60mmHg over normal (Have them lower arm - cuff will deflate about 30mmHg) Continue as normal
tangential lighting
Lighting used to create shadows to better view bumps
What are physical exam positions?
Standing Sitting Sitting and leaning forward Supine Supine on left side Supine with legs flexed
What are the cardinal techniques of examination?
Inspection - looking
Palpitation - feeling
Percussion - tapping
Auscultation - listening using stethoscope
What are the 6 steps in clinical reasoning?
- Identify abnormal findings
- localize findings anatomically
- Interpret
4, Make hypothesis - Test hypothesis
- Develop a plan
What is CAGE questioning?
Cutting down Annoyance when criticized Guilty feelings Eye openers It is used to assess alcohol addiction or illicit drug use
How do you diagnose hypertension?
The systolic goes up by 20's, and diastolic goes up by 10's. Normal: 120/80 prehypertension: 120-139/80-89 hypertension stage 1: 140-159/90-99 hypertension stage 2: 160+/100+
Components of skilled interviewing
Active listening Empathetic responses guided questioning nonverbal communication validation reassurance partnering summarization transitions empowering the patient
Making a problem list: what do you list first?
The most serious problem
